Each individual case of stuttering or stammering has its own peculiarities, already more or less developed—arising from structural differences (but not necessarily defects) in the organs of speech, as well as differences in temperament, health and nervousness; or peculiarities arising from habit—which is the result of previous training or neglect, as the case may be.
SING WITHOUT DIFFICULTY: Almost without exception, the stutterer or stammerer can sing without any difficulty, can talk to animals without stuttering or stammering, can talk when alone and in some cases can talk perfectly in a whisper. Some stammerers have less difficulty in talking to strangers than in talking to friends or relatives while in other cases, the condition is exactly reversed. A stutterer or stammerer almost always experiences difficulty in speaking over the telephone. One experimenter has shown, however, that a stammerer can talk perfectly over the telephone so long as the receiver hook is depressed and there is no connection with another person at the other end of the line. This experimenter shows that immediately the receiver hook is released and a connection is established, the halting, stumbling utterance begins.
These peculiarities of stuttering and stammering for many years puzzled investigators and were, in fact, finally responsible for arriving at the true cause of stammering.
Almost every stammerer seeks for an explanation of these peculiar manifestations. Why is it, for instance, that a stammerer can sing without difficulty, although he cannot talk? This is one of the best evidences that could be produced to show that stammering is the result of a lack of mental control. The stammerer who can sing without difficulty has no organic or inherent defect in the vocal organs, that is sure. If the stammerer can sing, and if this proves that he has no organic defect, then it follows logically that the cause of his trouble is mental and not physical.
TALK WHEN ALONE: The fact that a stammerer can talk without hesitation when alone and that he can talk to animals may be explained by a very simple illustration—any stammerer can try this experiment on one of his friends who does not stammer. He can prove that the reflex, or what might be termed subconscious movements of the bodily organs are more nearly normal than the same movements consciously controlled. Take, for instance, the regular beating of the pulse. Let anyone who does not stammer (it makes no difference in trying this experiment whether the person stammers or not, save that we are trying to prove that the condition may be brought about in one who is not a stammerer) feel his own pulse for sixty seconds. Let him be thoroughly conscious of this effort to learn the rapidity of its beating. If a disinterested observer could record the pulse as normally beating and the pulse under the conscious influence of the mind, it would be found that the pulse under the conscious effort is beating either more rapidly or more slowly or that it is not beating as regularly as in the case of unconscious or reflex action.
This same condition may be noticed in another unconscious or reflex action—breathing. The moment you become conscious of an attempt to breathe regularly, breathing becomes difficult, restricted, irregular, whereas this same action, when unconscious, is thoroughly regular and even.
In the average or normal person who has learned to talk correctly, speaking should be practically an unconscious process. It should not be necessary to make a conscious effort to form words, nor should a normal individual be conscious of the energy necessary to create a word or the muscular movements necessary to its formation and expression.
This will explain why the stutterer or stammerer can talk without difficulty to animals or when alone—there is no self-consciousness—no conscious effort—no thinking of what is being done.
Another of the peculiarities of stammering is that the stammerer in many cases seems to be able to talk perfectly in concert. This has long baffled the investigator in this field, no reason being assignable for this ability to talk in connection with others. The baffling element has been this—that the investigator has assumed that the stammerer talked well in concert, whereas a very careful scientist would have discovered the stammerer to be a fraction of a second or a part of a syllable behind the others.
You have doubtless been in church at some time when you were not entirely familiar with the hymn being sung, yet by lagging a note or two behind the rest, you could sing the song, to all appearances being right along with the others.
When you talk over the long-distance telephone, the voice seems instantly to reach the party at the other end of the line, yet we know that a period of time has had to elapse to allow the voice waves to move along the telephone wire and reach the other end. The elapse of time has been too slight to be noted by the average human mind and the transmission seems instantaneous. This is what happens in the case of the stammerer who seems able to talk in concert—he is merely a syllable or part of a syllable behind the rest, all the while giving the impression nevertheless, that he is talking just as they are.
There are many other individual peculiarities which can be described by almost every stammerer. These different peculiarities are more numerous than the cases of stammering and it would be useless to attempt to discuss them in detail. I will take up only two as being typical of dozens which have come under my observation in twenty-eight years' experience.
One stammerer explains his difficulty as follows: "I find I am unable to talk and do something else at the same time. For instance, I have difficulty in talking while dancing, while at the table or while listening to music. If, for instance, I wish to talk to any one while the Victrola is being played, I unconsciously cut it off." This is a case where the stammerer finds that all of his faculties must be concentrated upon a supreme effort to speak before this becomes possible. In other words, he has not yet learned to control sufficiently the different parts of his body so that they may act independently. This might be termed a lack of independent co-ordination.
In the case of another young man, he found himself unable to control the movements of his muscles. In describing his trouble, he said: "At one time, when I was talking particularly bad, I was out with some other fellows driving our car. I started to talk, found it almost impossible and noticed a sharp twitching of the muscles of face, arms and limbs. Try as I might, I found I could not control these movements and in another minute I had steered the car into the ditch and wrecked it. And now," adds the young man, "although father has a new car, I am never allowed to drive it!"
Here was a case where the spasmodic action of the muscles had gotten so far beyond control as to make the ordinary pursuits of life dangerous to the young man who stammered. These spasmodic movements were always present—he told of one occasion when he was in a barber's chair being shaved. He attempted to say a word or two while the barber was at work upon him, with the result that he lost control of the muscles of face and neck, causing the barber to cut a long gash in his neck.
This was, of course, an abnormal case of spasmodic stammering, evidencing extraordinary muscular contractions of the worst type. In practically every case of stammering some such peculiarity is evident, resulting from the inability of the stammerer's brain to control physical actions.
Paradoxical as the statement may seem, it is nevertheless true that one of the symptoms of least seeming importance marks one of the most dangerous aspects of both stuttering and stammering.
This is the alternating good-and-bad condition known as the Intermittent Tendency or the tendency of the stutterer or stammerer to show marked improvement at times.
This seeming improvement brings about a feeling of relief, the unreasoning fear of failure seems for the time to have left almost entirely; the mental strain under which the sufferer ordinarily labors seems to be no longer present; there is but little worry about either present condition or future prospects; the nervous condition seems to have very materially improved, self-confidence returns quickly and with it the hope that the trouble is gone forever or is at least rapidly disappearing. With these manifestations of improvement come also a greater ease in concentration, a greater and more facile power-of-will and an ambition that shows signs of rekindling, with worth-while accomplishments in prospect.
Hope now burns high in the breast of the stutterer or stammerer. They go about smiling inwardly if not outwardly, happy as the proud father of a new boy, at peace with the world. The sun shines brighter than it has for months or years. Every one seems much more pleasant and agreeable. Things which the day before seemed totally impossible seem now to come within their range of accomplishment. Such is the feeling of the confirmed stutterer or stammerer during the time of this pseudo-freedom from his speech disorder.
In his own mind, the sufferer is quite sure that his malady has disappeared over-night, like a bad dream and that freedom of speech has been bestowed upon him as a gift from the gods on high.
The higher the hopes of the sufferer and the greater the assurance with which he pursues the activities of his day, the greater is his disappointment and despair when the inevitable relapse overtakes him.
For disappointment and despair are sure to come—just as sure as the sun is to rise in the heavens in the morning. The condition of relief is but temporary, and will soon pass away to be followed by a return of his old trouble in a form more aggravated than ever before.
Fate seems to play with the stammerer's affliction as a cat plays with a mouse, allowing him to be free for a few hours, a few days or a few weeks as the case may be, only to drag the dejected sufferer back to his former condition—or, as is true in many cases, worse than before.
THE RECURRENCE: With the return of the trouble, the bodily and mental reaction are almost too great for the human mechanism to withstand. Hope seems to be a word which has been lost from the life of the stammerer. The fear of failure returns with an overwhelming force mocking the sufferer with the thought of "Oh, how I deceived you!!"; the mental strain is exceedingly great—so great, in fact, that it seems as if the breaking point has almost been reached. The nervous condition is alarming, the sufferer noting in himself an inability to work, to play, to study or even to sit still. An observer would note the stammerer or stutterer in this condition fingering his coat lapels, putting his hands in his pockets and removing them again, biting his finger nails, constantly shifting eyes, head, arms and feet about. If at home, the sufferer in this condition would probably be seen walking about the house, unable to read, to play or listen to music or to follow any of the accustomed activities of his life. If in business or in the shop, he would be noticed making frequent trips to the wash room, to the drinking fountain, to the foreman, picking up and laying down his tools, looking out the window, shifting from one foot to another, all of which symptoms indicate an acute nervous condition, brought about by the return of his trouble.
At this stage, the stammerer's confidence is hopelessly gone, so it seems, and this feeling is accompanied by one of depression which finds an outlet in the expression of the firm belief and conviction on the part of the stutterer or stammerer that the disorder can NEVER be cured, by any method, although just the day before the same sufferer would have insisted that his stuttering or stammering had CURED ITSELF and left of its own accord.
These conditions, both at the time of the so-called improvement and at the time of the recurrence of the trouble, will appear in greater or less degree in the case of every stutterer or stammerer whose trouble is of the intermittent type.
THE DANGERS OF THIS TENDENCY: This period of recurrence is accompanied by almost total loss of the power-of-will, a marked weakening in the ability to concentrate, and if it does not result in insomnia (inability to sleep) puts the mind in such a state as to make sleep of little value in building up the body, replacing worn-out tissue cells and restoring vital energy.
The chief danger, however, resulting from these periods of temporary improvement, is the belief that it instills into the mind of the sufferer and more frequently into the minds of the parents of stuttering or stammering children, that the trouble will cure itself—a fallacy greater than which there is none.
Stuttering and stammering are destructive maladies. They tear down both body and mind but they have not the slightest power to build up. And until a strong mental and physical structure has been built up in place of the weakened structure (which results in stammering and stuttering) a cure is out of the question.
The spell of intense recurrence of either stammering or stuttering which follows a period of improvement, often marks the period of transition from one stage of the disorder into the next and more serious stage. This transition, however, may not be a conscious process—that is, the sufferer may not in any way be informed of the fact that he is passing into a more serious stage of his trouble save that after the transition has taken place, he may find himself a chronic or constant stammerer and in a nervous and mental condition much more acute than ever before.
Dr. Alexander Melville Bell (father of Alexander Graham Bell, inventor of the telephone), who, before his death, was a speech expert of unquestioned repute, discovered this condition many years ago and in his work PRINCIPLES OF SPEECH speaks of it as follows (page 234):
"Often the transition from simple to more complicated forms of difficulty is so rapid, that it cannot be traced or anticipated. Perhaps some slight ailment may imperceptibly introduce the higher impediment or some evil example may draw the ill-mastered utterance at once into the vortex of the difficulty."
This Progressive Tendency, which we shall hereafter call the Progressive Character of the trouble in order to distinguish it from the Intermittent Tendency, is present in more than 98 per cent, of the cases of stammering and stuttering which I have examined and diagnosed.
True, there are many cases, the apparent or manifest tendencies of which do not indicate that the disorder is becoming more serious, but nevertheless this condition is no indication that the trouble is not busily at work tearing out the foundation of mental and bodily perfection.
SUCCESSIVE STAGES: Stuttering may be conveniently divided into four stages, by which its progress may be measured. These may be designated in their order as:
1—Simple Phase2—Advanced Phase3—Mental Phase4—Compound Phase
The progress of the disorder is sure. Take the case of a child eight years of age who has a case of simple stuttering. Permit the child to go without attention for some time and the trouble will have progressed into the Advanced Phase, usually without the knowledge of the child or his parents or without any especially noticeable surface change in his condition.
Stuttering in its first phase—Simple Stuttering—can justly be called a physical and not a mental trouble. In this stage, the disorder should be easily eradicated. The duration of cases of Simple Stuttering is very slight, for the reason that Simple Stuttering soon passes into the Advanced Phase, which is of a physical-mental nature, exhibiting the symptoms of a mental disturbance as well as of a physical difficulty.
From the Advanced Phase stuttering then passes into the Mental Phase, where the mental strain is found to be greatly intensified and the disorder a distinct mental type instead of a physical or physical-mental trouble.
When stuttering in this stage is permitted to continue its hold upon the sufferer, the continued strain, worry and fear bring about a condition of extraordinary malignancy, in which the trouble develops into the Chronic Mental Stage. This is a condition bordering upon mental breakdown and even though the complete breakdown never occurs, the one afflicted finds himself a chronic stutterer, without surcease from his trouble. He further finds that he has increasing difficulty in thinking of the things which he wishes to say. He seems to know, but his mind refuses to frame the thought. In other words, he is unable to recall the mental image of the word in mind, and is therefore unable to speak the word. This is a condition known as Aphasia or Thought Lapse and represents a most serious stage of the difficulty, in many cases totally beyond the possibility of relief—a condition in which no stutterer should allow himself to get.
Stammering, being a kindred condition to stuttering, progresses from bad to worse in a manner very similar. The progress of stammering may be classified into successive stages as follows:
1—Elementary Stage2—Spasmodic Stage3—Primary Mental Stage4—Chronic Mental Stage5—Compound Stage
Stammering in the Elementary Stage, like Stuttering, is a Physical Trouble. The Stammerer has often been known to remain in the Elementary Stage only a few days or a few weeks, passing almost immediately into either the Spasmodic or the Primary Mental Stage. Not all stammerers pass into the Spasmodic Stage of the disorder, however, some passing directly into Primary Mental Stage.
The Spasmodic Stage, however, is a form of difficulty somewhat akin to the Advanced Phase of Stuttering, for in this stage the trouble can be said to be of Physical-Mental nature instead of the purely physical disorder found in Elementary Stammering.
Stammering, in the Primary Mental Stage, takes on a distinct Mental form as differentiated from the Mental-Physical form and becomes therefore more difficult to eradicate. If allowed to continue, this form of Stammering (like Stuttering) passes into the Chronic Mental Stage, in which case the Stammerer usually exhibits pronounced signs of Thought Lapse and finds himself a Chronic or Constant Stammerer, often unable to utter a sound-and further at times unable to THINK of what he wishes to say.
The progress of both Stuttering and Stammering from one stage to another is very certain. These speech disorders do not differ materially from other human afflictions in this respect—they do not remain constant. There is an axiom in Nature, that "Nothing is static," which, being interpreted, means, that nothing stands still. And this applies with full force to the stutterer or stammerer. If no steps are taken to remedy the malady, he may be very sure that the disorder is getting worse—not standing still or remaining the same.
Probably the most harmful and oft-repeated bit of advice ever given to a stammerer or stutterer is that which says, "Oh, don't bother about it—you will soon outgrow the trouble!" It is the most harmful because it is palpably untrue. It is so oft-repeated because the person giving the advice knows nothing whatever about the cause of stammering and just as little about its progress or treatment.
The fact that we hear of no cases of stuttering or stammering which have been outgrown does not seem to alter the popular and totally unfounded belief that stammering and stuttering can be readily outgrown.
If the reader has not read the chapter on the causes of stuttering and stammering and the two preceding chapters on the Intermittent Tendency and the Progressive Character of these speech disorders, then these chapters should be read carefully before going further with this one, because it is essential to know the cause of the trouble before it is possible to answer intelligently the question, "Can Stammering be Outgrown?"
To any one who understands the nature of the difficulty and the progress it is liable to make, the question is almost as absurd as asking whether or not the desire to sleep can be outgrown by staying awake. But aside from its scientific aspect—aside from the absurdity of the question—let us examine the facts as revealed by actual records of cases. Let us dispense with all theory on the subject and take experience gained in a wide range of cases as the correct guide in finding the answer.
FACTS FROM STATISTICS: An examination of the records of several thousand cases of stuttering and stammering of all types and in all stages of development reveals the fact that after passing the age of six, only one-fifth of one per cent, ever outgrow stammering. This means that out of every five hundred people who stammer, only one ever outgrows it. Between the ages of three and six, the indications are more favorable, the records in these cases showing that slightly less than one per cent, outgrow the difficulty. That means that one out of every hundred children affected has a chance, at least, of outgrowing the difficulty between the ages of three and six, and after that time, only one chance in five hundred.
Suppose you were handed a rifle, given five hundred cartridges and told to hit a bull's eye at a hundred yards, 499 times out of 500. Suppose you were told that if you missed once you would have to suffer the rest of your life as a stammerer.
Would you take the offer? Certainly not!!!
And yet that is exactly the opportunity that a stammerer over six years of age has to outgrow his trouble.
Dr. Leonard Keene Hirschberg, the medical writer, whose suggestions appear daily in a large list of newspapers, has this to say about the possibility of outgrowing stammering:
"Often when the attention of careless and reckless fatalistic relatives is attracted to a child's stammering, they labor under the mistaken illusion that the child 'will outgrow it.' A more harmful doctrine has never been perpetuated than the one contained in that stock phrase. As a matter of experience, speech troubles are not 'outgrown.' They become 'ingrown.' If not corrected at first they go from bad to worse. So firmly rooted and ingrained into the child's habits does stuttering become that with every hour's growth the chance for a cure becomes farther and farther removed."
This statement from Dr. Hirschberg is a straight-forward, practical and common-sense view of the subject.
The belief that the child will outgrow the malady often springs out of the tendency of the stammerer to be better and worse by turns, a condition which is fully described and explained in the chapter on the Intermittent Tendency. There is always present in any case of stammering the opportunity for a cessation of the trouble for a short period of time. The visible condition is changeable and it is this particular aspect of the disorder that renders it deceptive and dangerous, for many, who find themselves talking fairly well for a short period, believe that they are on the road to relief, whereas they are simply in a position where their trouble is about to return upon them in greater force than ever.
From the nature of the impediment—lack of co-ordination between the brain and the organs of speech—stammering cannot be outgrown—no more so than the desire to eat or to talk or to sleep.
Back of that statement, there is a very sound scientific reason that explains why stammering cannot be outgrown. Stammering is destructive. It tears down but cannot build up. Every time the stammerer attempts to speak and fails, the failure tears out a certain amount of his power-of-will. And since it is impossible for him to speak fluently except on rare occasions, this loss of will-power and confidence takes place every time he attempts to speak, so that with each successive failure, his power to speak correctly becomes steadily lessened. The case of a stammerer might be compared to a road in which a deep rut has been worn. Each time a wagon passes through this rut, it becomes deeper. The stammerer has no more chance of outgrowing his trouble than the road has of outgrowing the rut.
Dr. Alexander Melville Bell recognizes the absolute certainty of the progress of stammering and the impossibility of outgrowing the difficulty, when he states in his work, PRINCIPLES OF SPEECH (page 234):
"If the stammerer or stutterer were brought under treatment before the spasmodic habit became established, his cure would be much easier than after the malady has become rooted in his muscular and nervous system."
To the stammerer or stutterer or the parents of a stammering child, experience brings no truer lesson than this: Stammering cannot be outgrown; danger lurks behind delay.
It is hardly necessary to describe to the stammerer who has passed beyond the first stage of his trouble the effect of stammering on the mind. Most any sufferer in the second or third stages of the malady has experienced for very brief periods the sensation of thoughts slipping away from him and of pursuing or attempting to pursue those thoughts for some seconds without success, finally to find them returning like a flash.
The stammerer who recalls such an incident will remember the feelings of lassitude or momentary physical exhaustion, as well as the feeling of weakness which followed the lapse-of-thought. This mental flurry is but an indication of a mental condition known as Thought-Lapse, which may result from long-continued stammering, especially a case which has been allowed to progress into the Chronic or Advanced Stage.
A CASE OF APHASIA: One writer, in citing instances of thought-lapse, or aphasia, tells of the case of a man unable to recall the name of any object until it was repeated for him. A knife, for instance, placed on the table before him, brought no mental image of the word representing the object, yet if the word "knife" were spoken for him, he would immediately say, "Oh, yes, it is a knife."
A chapter could be filled with instances of this sort, but I shall not attempt to quote further any of the symptoms of aphasia in a stammerer, for in cases that become so far advanced, there is considerable question as to the possibility of bringing about a cure. I say this, notwithstanding the fact that my experience with students having this tendency has been very satisfactory indeed.
Cases of unreasoning despondency, which result in the stammerer's desire to take his own life, are so numerous as hardly to require comment. Very frequently you see in some of the large metropolitan papers an account of a suicide resulting from a nervous and mental condition brought on by stuttering and stammering. This condition seems to be very marked in the cases of stammerers between the ages of twelve and twenty, records showing that most of the suicides of stammerers are persons between those ages.
The intense mental strain, the extreme nervous condition, the continual worry and fear cannot fail, sooner or later, to have its effect upon the mind. This is clear to any stammerer, who is familiar with the mental condition brought about by the first few hours of one of his periods of recurrence. Another case where the mental strain is extremely great is that of the synonym stammerer—the mentally alert individual who, in order to prevent the outward appearance of stammering, is continually searching for synonyms or less difficult words to take the place of those which he cannot speak. This continual searching for synonyms results in a nervous tension that is sure to tell on the mental faculties sooner or later, and I have found, in examining many thousands of cases, that the synonym stammerer is usually in a more highly nervous state than any other type.
MENTAL STRAIN EVENTUALLY TELLS: The effect of stuttering or stammering on the sufferer's concentration is very marked. The sufferer notes an inability to concentrate his mind on any subject for any length of time, finds it impossible to pursue an education with any degree of success or to follow any business which requires close attention and careful work.
The power-of-will is also affected and the stammerer notes an inability to put through the things which he starts and which require the exercise of will power to bring to a successful conclusion.
A diagnosis of insanity is sometimes made in the case of a stammerer in the advanced stages of his malady, while in other instances the mental aberration takes the form of a hallucination of some sort, as in the case of the boy who was of the belief that he was continually being followed.
But regardless of what form is taken by the mental disorder resulting from stammering, such cases are almost invariably found to have long since passed into the incurable stage, although positive statements as to the individual's condition should not be made, as a rule, without a thorough diagnosis having first been made.
The effect of stammering or stuttering upon the physical structure is problematical. In some cases examined, a noticeable lack of vitality has been found, together with an almost total loss of active appetite, a marked inclination toward insomnia and a generally debilitated condition resulting from the nervous strain and continued fear brought on by the speech disorder.
In other cases, it has been found that the health was but little affected and that there was no marked departure from normal.
The physical condition of the stammerer is the result of many factors. If plenty of fresh air and exercise is supplied, and the mind is well-employed so that the worry over the trouble does not disturb the stammerer, then the chances for being in a normal physical condition are good.
On the other hand, the boy of studious disposition, who is somewhat of a bookworm, keeps close to the house and does not play with other children of his age, will probably find time for much introspection, and on this account, as well as on account of the lack of fresh air and exercise, will probably be in a physical condition that of itself demands careful attention.
It has been found in examinations of stammerers and stutterers, however, that they are usually of below normal chest expansion and that the health, while not particularly bad, is subject to a great improvement as a result of the proper treatment for stammering.
Charles Kingsley, the noted English divine and writer, and himself a stammerer many years ago, has the following to say regarding the effect of stammering on the body: "Continual depression of spirit wears out body as well as mind. The lungs never act rightly, never oxygenate the blood sufficiently. The vital energy continually directed to the organs of speech and there used up in the miserable spasm of mis-articulation cannot feed the rest of the body; and the man too often becomes thin, pale, flaccid, with contracted chest, loose ribs and bad digestion. I have seen a boy of twelve stunted, thin as a ghost and with every sign of approaching consumption. I have seen that boy a few months after being cured, upright, ruddy, stout, eating heartily and beginning to grow faster than he had ever grown in his life. I never knew a single case in which the health did not begin to improve then and there."
From the standpoint of speech development, the life of any person between the time of birth and the age of twenty-one years, may be divided into four periods as follows:
From Birth to Age 2—PRE-SPEAKING PERIOD.Age 2 to Age 6—FORMATIVE-SETTING PERIODAge 6 to Age 11—SPEECH-SETTING PERIODAge 11 to Age 20—ADOLESCENT PERIOD
This chapter will deal only with the first period of the child's speech-development, beginning with birth and taking the child up to his second year. The speech disorders of the later periods will be taken up in the three following chapters.
THE PRE-SPEAKING PERIOD: This is the period between the time of birth and the age of 2, and takes the child up to the time of the first spoken word. This does not mean, of course, that no child speaks before the age of 2, for many children have made their first trials at speaking at as early an age as 15 months, and many begin to talk by the time they are a year and a half old. At the age of two, however, not only the precocious child but the child of slower-than-average development should be able to talk in at least brief, disjointed monosyllables.
Before taking up the possibility of a child exhibiting symptoms of defective speech with the first utterance, let us familiarize ourselves with the fundamentals underlying the production of the first spoken words.
The mother, who for months, perhaps, has been listening with eager interest and fond anticipation for her child's first word to be spoken, has little comprehension of the vast amount of education and training which the infant has absorbed in order to perfect this first small utterance. Months have been spent in listening to others, in taking in sounds and recalling them, in impressing them upon the memory by constant repetition, until finally after a year and a half, or more, perhaps, the circuit is completed and the first word is put down as history.
ASSOCIATION OF IDEAS: It must be remembered that perfect co-ordination of speech is the result of many mental images, not of one. In saying the word "salt," for instance, you have a graphic mental picture of what salt looks like; a second picture of what the word sounds like; a "motor-memory" picture of the successive muscle movements necessary to the formation of the word; another picture that recalls the taste of salt, and still another that recalls the movements of the hand necessary to write the word.
These pictures all hinging upon the word "salt" were gradually acquired from the time you began to observe. You tasted salt. You saw it at the same time you tasted it. There you see was an association of two ideas. Thereafter, when you saw salt, you not only recognized it by sight, but your brain recalled the taste of salt, without the necessity of your really tasting it. Or, on the other hand, if you had shut your eyes and someone had put salt on your tongue, the taste in that case would have recalled to your mind the graphic picture of the appearance of salt.
As you grew older and learned to speak, your vocal organs imitated the sound of the word "salt" as you heard it expressed by others and thus you learned to speak that word. At that stage, your brain was capable of calling up three mental pictures—an auditory picture, or a picture of the sound of the word; a graphic or visual picture, or a picture of the appearance of salt and a third, which we have called a motor-memory picture, which represents the muscular movements necessary to speak the word. A little later on, after you had gone to school and learned to write, you added to these pictures a fourth, the movements of the hand necessary to write the word "salt."
At the sight of the mother, a child may, for instance, be heard to say the word "Mom" while at the sight of the pet dog whose name is "Dot," be heard to say "Dot" in his childish way.
Here we have the first example in this child of the association of ideas. The child has heard, repeatedly, the word "Mama" used in conjunction with the appearance of the smiling face of his mother. Thus has the child acquired the habit of associating the word "Mama" with that face—and the sight of the countenance after a time recalls the sound of the associated word. Thus a visual image of the mother transmitted to the child through the medium of the eye, links up a train of thought that finally results in the child's attempt to say "Mama."
To take another example of the association of ideas or the co-ordination of mental images necessary to the production of speech, let us suppose, for instance, that the child has been in the habit of petting the dog and hearing him called by name "Dot" at the same time. Now, if the dog be placed out of the child's sight and yet in a position where the hand of the child can reach and pet him in a familiar way, this sense of touch, like the sense of sight, will set up a train of thought that results in the child making his childish attempt to speak the name of the dog "Dot."
In other words the excitation of any sensory organs sets up a series of sensory impulses which are transmitted along the sensory nerve fibres to the brain, where they are referred to the cerebellum or filing case, locating a set of associated impulses which travel outward from the motor area of the brain and result in the actions, or series of actions, which are necessary to produce a word.
It will make the action of the brain clearer if the reader will remember the sensory nerve fibres as those carrying messages only TO the brain, while the motor nerve fibres carry messages only FROM the brain.
To make still clearer this association of ideas so necessary to the production of speech, suppose this same child hears the word "Dot" spoken in his presence. He will, in all probability, begin to repeat the word, and to search diligently for his pet dog. Thus it will be seen that in this case the sound of the dog's name has stirred up a train of mental images, one of these being a visual image of the dog himself, causing the child to look about in search for him.
HOW WE LEARN TO TALK: We learn to talk, therefore, purely by observation and imitation. Observation is here used in a broad sense and means not only SEEING but SENSING, such as sensing by smelling, touching or tasting. The child imitates the sounds he hears and if these sounds emanate from those afflicted with defective utterance, then it follows that the initial utterance of the child will be likewise defective.
SOURCE OF THE FIRST WORD: The first spoken word of the child usually finds its source in some name or word repeatedly spoken in the child's presence. It is not usual that this first word is marked by a defective utterance and if such should be the case, then it is safe to say that this faulty utterance can be traced back to the imitation of some member of the family, or some child who has been permitted to talk to the child in his pre-speaking period. There is little to be gained by tracing the first word back, for no very profound conclusion can safely be registered with such a basis, for no matter what the word be and no matter whether it be correctly or imperfectly enunciated, it is the result of imitation.
There may be two exceptions to this, however, one being the case of a child with a physical defect in the organs of speech and the other that of a child who has inherited from the parents a predisposition to stammer or stutter. These exceptions, however, are so rare as to hardly require consideration. In the first (that of a physical defect) it is hardly probable that an organic defect would manifest itself in the form of stuttering or stammering, but rather in some other form of defective utterance. In the case of the inherited predisposition to stutter or stammer, there is always the question which has contributed more largely to the defective utterance—the inherited predisposition or the association with others who speak in a faulty manner.
ADVICE TO PARENTS: It is very essential that from the very beginning of the period of the recording of suggestion, the child is shown the correct and customary utterance with the best method of its accomplishment. The child should not be subjected to constant repetitions of phonetic defects, imperfect utterance or speech disorders of any sort. The child who hears none but perfect speech is not liable to speak imperfectly, or at least not so liable as the child who hears wrong methods of talking in use at all times, for this last cannot escape the effects of his environment.
The period in a child's speech development dating from the second year and up to the sixth, is called the Formative Period, for the reason that this is the time when the child is busy learning new words, acquiring new habits of speech, co-ordinating and learning properly to associate the flood of ideas which overwhelm the child-mind in this period.
The child-vocabulary at this time is but an echo of the vocabulary of the home. The words that have been used most frequently there are most strongly impressed upon the child-mind. The names he has heard, the objects he has seen, the applications of speech-ideas—these alone are now in his mind. This condition is inevitable since the child must learn to speak by imitation—and, since he has had no source of word—pictures other than the home, he must have acquired facility in the use of only those words he has had an opportunity to hear.
Former President Wilson, whose faultless diction, remarkable fluency of expression and discriminating choice of words, made him a master speaker and writer, attributed his facility to the training he received in the home of his father, a minister, where the children were constantly encouraged in the use of correct English and in the broadening and enrichment of their store of words.
From the form of simple child-speech, made up often of monosyllables or of a few brief and easy sentences, the child must now evolve a more complicated form of thought-expression, with the use of connectives, descriptions and a finer gradation of color than heretofore.
This process may be materially aided by the parent by the repetition of the child's own utterances, proving to the child that these are correct, that he is being understood and giving him confidence to venture further out in his attempts at speech amplification. This encouragement of the child-mind in its attempts to speak is so important that it is worth while to give some simple examples of what is meant, in order that the point may be clearly understood. Let us take, first, the example of a mother who, from some cause, allows herself to be of a nervous and irritable disposition. The small child may say, "Mam—ma, I want a tooky." The mother, either through indifference or through habit, says, "You want WHAT?" This, first of all, is like a dash of cold water to the child in his uncertain state of mind as to the correctness of his utterance. The child repeats, "I want a tooky," and in all probability gets the further inquiry, "You want a TOOKY—what's that?" which undermines the child's confidence in himself and in his ability to talk.
On the other hand, the mother who understands the needs of the child from a speech-forming standpoint will not insist on the child repeating the word time after time as if it was not understood. She will strive hard to understand the first time, even though the expression is imperfect and difficult of interpretation, and her nimble mind having figured out what it is that the child desires, will say, "Baby wants a cooky?" Here the child, in his comparatively new occupation of talking, finds a deal of delight in knowing that his words have been properly comprehended and feels a new confidence in his ability to express thoughts—which confidence, by the way, is essential to normal speech development in the child. It has the further effect of correcting the tendency of faulty utterance, and in time will result in the complete eradication of the natural tendency to "baby-talk" which is too often encouraged and aided by the habit of parents in REPEATING THE BABY-TALK. In no case, should defective utterances be repeated, no matter how "cute" the utterance may seem at the time. Many speak indistinctly throughout their entire life simply because of the habit of their parents in repeating baby-talk, thus confirming incorrect images of numerous words.
SPEECH DISORDERS IN THE FORMATIVE PERIOD: The Formative Period may mark the beginning of a speech disorder and in many instances chronic cases of stuttering and stammering may be traced to a simple disorder which first manifested itself in the ages between 2 and 6.
Speech disorders arising in this period may be traced to any one of a number of causes. In a child of five, for instance, the diagnostician would look for evidences of an inherited tendency to stammer or stutter; he would look also for circumstances which would show that the child had acquired defective utterance through mimicry of others similarly afflicted or through the unconscious imitation of the defective speech of those immediately about him.
Failing to find any hereditary tendency to a speech defect or any evidence that the disorder had been acquired by imitation or mimicry, the next step would be to determine whether or not the trouble had been caused by disease or injury.
As explained in Chapter III, the diseases of childhood, such as Whooping Cough, Scarlet Fever, Diphtheria, Acute Chorea, Infantile Cerebral Palsy and Infantile Paralysis are frequently the cause of stuttering or stammering, and a history showing a record of these diseases would result in a very careful examination for the purpose of determining if they had resulted in a form of defective utterance.
ADVICE TO PARENTS: But whatever the cause of the trouble, care should be taken to see that it grows no worse and every attempt should be made to eradicate it at this early stage. Like a fire, speech disorders in their early stages are insignificant compared to their future progress and can be much more readily eradicated then than later. Inasmuch as a child of less than eight years is hardly old enough to undertake institutional treatment successfully, it behooves the parent of the stammering or stuttering child to render what home assistance is possible, during this period. The old adage, tried and true, that "An ounce of prevention is worth a pound of cure" is never more correctly applied than here. A few simple suggestions may aid in preventing the trouble from progressing rapidly to a serious stage, even though these suggestions do not eradicate the disorder altogether.
First of all, the child should be kept in the very best possible physical condition. This means, too, plenty of fresh air and sunshine, without which any child is less than physically fit.
It is important that the child be not allowed to associate with others who stammer or stutter, or who have any form of speech disorder. Imitation or mimicry, as heretofore stated, is the most prolific cause of speech trouble and to place a child who stammers or stutters in the company of an older person similarly afflicted, is to invite a serious form of the disorder.
Nervousness, while not the cause of speech disorder, is an aggravant of the trouble and should be avoided. The child should not be allowed to engage in anything which has a tendency to make him nervous or highly excited. Such a condition will aggravate the speech trouble, make it worse and tend to fix it more firmly in the child.
Furthermore, parents should not scold or berate the child because he stammers or stutters. No child stammers or stutters because he wants to, but because he has not the power to control his speech organs. In other words, the child cannot help himself—and scolding and harsh words simply cause confusion and dejection which in turn react to make a more serious condition.
THE CHANCES FOR OUTGROWING: The author's examination and diagnosis of more than 20,000 cases of speech disorders has revealed the fact that at this period in the life of the child afflicted with stammering or stuttering, slightly less than 1 percent. outgrow the difficulty. With proper parental care it might be possible to increase this percentage, perhaps double it, but this should hardly be called "outgrowing." In the mind of the average person, the expression "outgrowing his stammering" means that the stammerer has been able to go ahead without giving the slightest heed to his trouble and that it has, by some magical process, ceased to exist. This is a fallacy. Stammering and stuttering are both destructive and progressive and no amount of indifference will result in relief—but on the other hand, will terminate in a more malignant type of the disorder. It IS true, however, that more care on the part of the parent in looking after the formation of speech habits in the Pre-Speaking and Formative Periods of the child's speech development, would result in fewer cases of chronic stammering and stuttering in later life.